1-3 The Terrace P.O Box 5013 Wellington Date: 2 September 2014 Pages: 1 of 2 To: General Practitioners, Practice Nurses, Practice Managers, Health Professionals From: Rayoni Keith, Manager, Immunisation Subject: Coverage Update, Enrolment of newborns, New immunisation resources, BCG vaccine, ADT vaccine shortage, Influenza, Four year old recalls Coverage update from Immunisation Champion Dr Pat Tuohy The efforts being undertaken around the country to lift immunisation rates for eight month olds to 95 percent are having a definite impact, with an increasing number of DHBs lifting their regional figures. Your hard work, systems and processes are enabling these improved immunisation coverage rates. Congratulations and thank you for your efforts to improve the health of our children. The provisional coverage has increased to over 92 percent. Enrolment of newborns The national rate for newborns enrolled with a general practice has reached 71 percent. There has been a great deal of effort invested to achieve this rate of coverage, and we urge everyone to continue working with a focus on getting newborns enrolled as soon as possible after birth. There are still too many babies at risk of late immunisations or unable to access free medical care when it is needed because they are not enrolled early enough. Your local NIR administrator may contact you with a list of babies that need enrolling in your area. If you haven’t already, please take the time to read these resources to assist you with early newborn enrolment: www.health.govt.nz/our-work/primary-health-care/primary-health-caresubsidies-and-services/newborn-enrolment-general-practices New immunisation resources Resources to support the 2014 National Immunisation Schedule changes are available, and can be ordered from HealthEd (www.healthed.govt.nz – click on “Immunisation and vaccinations” and sort by revision date). Please discard editions of the following resources that were published before 2014, as they contain out of date information: HE1308 National Immunisation Schedule Card, HE1323 Childhood Immunisation, HE1327 Immunise Your Children, and HE1504 After your child is immunised. New editions of HE1309 (Immunisation Record) and HE7013 (Immunisation Certificate) include RotaTeq and Prevenar 13. It is not necessary to replace a child’s old immunisation record or certificate unless it has been lost. The new Immunisation Record sticker should only be used for babies who have the old Well Child Tamariki Ora Book but are eligible for rotavirus vaccine, eg those born between 19 March and 1 July 2014. The stickers will soon be discontinued. For children born before 19 March 2014 who have not received rotavirus vaccine, but need a new Certificate, the checkbox for rotavirus should be marked as “n/a” (not applicable). They should still be recorded as fully immunised providing they have received all the immunisations funded for their age. BCG BCG vaccine is available again in New Zealand, and some public health services have started vaccinating at-risk babies and children. While the BCG vaccine is safe, and is essentially the same vaccine that was used in New Zealand until April 2014, its new distributor, bioCSL, is seeking Medsafe approval of minor historical changes to the vaccine. Until Medsafe consent is granted, the BCG vaccine will not be classified as an approved medicine in New Zealand. To avoid further delays in making the vaccine available, some Medical Officers of Health have endorsed the supply of the BCG vaccine in their regions under Section 29 of the Medicines Act 1981. Section 29 permits the sale or supply to medical practitioners of medicines that have not been approved. Please check with your local public health service to see if they have recommenced their BCG vaccine clinics. ADT Booster (Td) vaccine shortage There is currently a shortage of ADT Booster vaccine, which is offered at ages 45 and 65 years and for tetanus prone wounds. PHARMAC have advised that Boostrix (Tdap) may be used in the short term as a replacement for ADT Booster once your existing ADT Booster stocks have been used. ADT Booster vaccine stock is expected to arrive at the end of September. No safety concerns are expected with the use of Tdap instead of Td. Refer to the tetanus chapter in the Immunisation Handbook 2014 for more information. Influenza The publicly funded influenza programme closed on 31 August 2014. Influenza vaccine remains available for people not eligible for free immunisation, but they must pay for it. All claims for funded vaccines must be submitted by 20 December 2014. Claims will not be accepted after this date. An eligible child under 9 years of age who has never previously been vaccinated against influenza is recommended to have two doses of the vaccine. If the first dose was given in August, the second dose may be given in September and will be funded. An immunisation payment claim for a child’s second dose given in September will need to be submitted manually. A refund will be provided for a total of 10 units of unused stock of seasonal influenza vaccine, either Influvac or Fluarix (only one brand, not both) from any one account returned by 30 September 2014. For further information on ordering the funded vaccines, please phone Healthcare Logistics Customer Services on 0508 425 358. For further information regarding the programme please call 0800 IMMUNE. Additional information about the current influenza situation is available at https://surv.esr.cri.nz/virology/influenza_weekly_update.php. Four year old immunisation recalls It is important that all four year olds receive their immunisations to protect them from diseases like measles. At the 1 July schedule change the PMS and NIR recalls were brought forward by six months. PMSs now recall at four years one month and the NIR recalls at four years six months. If you have any queries about anything in this update, please email immunisation@moh.govt.nz.